Laser Rosacea TreatmentAlso, you should NOT have a dermabrasion treatment on the affected area if you have the following:
*source for the immediate above, Medscape Medical Journal (1999) After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation. You will meet with these surgeons and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take, etc. - this is very important. You really should consider smoking cessation as this can significantly decrease healing. You will discuss your complaints and concerns and discuss the various "levels" which can be safely removed, thus the amount that can be improved, etc. Your surgeon will explain the technique or methods that may be most appropriate for you. He or she should discuss the risks associated with dermabrasion with you, as well. You will also discuss the available anesthesia that will be used for your procedure. Most dermabrasion procedures are performed under light sleep sedation, twilight or regional - sometimes even local with oral sedation. However, some physicians may use general IV sedation. Either way, discuss this beforehand as many people are not aware of the risks of anesthesia. If you do go under deep general, ascertain that the anesthesiologist is certified. You will also discuss your pre-operative instructions and speak about the recovery period instructions and what to expect in the months ahead. You will be given prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines, prescription anti-inflammatory drugs. Please do not hesitate to address any concerns that you may have during this time and even after your pre-operative appointment. If you remember something when you get home or the next day or even the day of treatment - don't be afraid to ask. You should be given an information packet that explains everything you should do and know before your treatment date. For more invasive procedures, the packet should include a list of all the medications you should not take starting usually at 2 weeks before your treatment. These medications will include, but are not limited to, aspirin containing products, stimulants, seratonin supplements, etc.. Also, if your surgeon advised that you may take Arnica montana, Bromelain, Vitamin K, etc. for swelling and bruising you should either have this in your packet or begin shopping for your necessities. It is quite possible that you will have "blood work" performed. This is normally an extra out-of-pocket expense that the patient must participate in to check your white and red blood cell count and check for disease or disorders beforehand. If you are a female they may take an extra vial for a pregnancy test. Some surgeons ask that you have physical. This can be yet another out of pocket expense so ask at your consultation what will be needed when you are quoted a price. For less invasive or minimal correction procedures, the routine is much simpler - please discuss this aspect with your physician. During a dermabrasion procedure, the surgeon moves an instrument attached to a spinning wheel over the problem area, resurfacing the top layer of skin. The goal is to polish the surface down to the lowest level of scarring or acne, or to wear away facial wrinkles. Dermaplaning is a more subtle procedure, performed with a hand held instrument called a dermatome. These procedures are usually performed on an outpatient basis and last anywhere from fifteen minutes to over an hour, depending on the severity and size of the area to be resurfaced. A dermabrasion procedure normally takes anywhere from 15 minutes to 2 hours to perform - depending upon the size of the area to be corrected. For patients undergoing anesthesia for their procedure, first, you will have monitoring "pads" (electrodes) attached to you so that the surgical team can properly monitor your vital statistics before, during and after your operation. When you are brought to the operating room, your electrodes will be connected to the monitoring equipment. Once you are on the operating room table, you will then be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date. If you had been given an oral sedative or valium prior you will have less anxiety. They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular "doorway" for anesthesia, antibiotics, and other medications. If you haven't been given a sedative, it is more stressful for some patients. If you feel that you may experience anxiety inquire beforehand regarding an oral sedative. Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time. It's the initial placement of the IV that may sting a bit. Some people get their IV placed in the crook of the elbow, some the hand - it all depends upon your veins though. So if your veins are not very prominent this can be a problem. You are then brought to the O.R. if you aren't on the table yet. After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein. This is called a "catheter". The catheter is taped to your skin so it is not accidentally knocked or pulled out and is ready to be used as a sort of entryway for anything the surgical team deems necessary for your body. This is usually done before you get into the actual O.R. - by a nurse - and you have a saline bag hooked up to you. The medications will usually be given with a drip system with this saline. As said before, the saline will keep you hydrated both during and post-operatively. If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body. The effects of the anesthesia are felt soon after injection or opening the stopper - a few seconds in fact. It may feel similar to a sensation of "heat" entering your arm or hand at the catheter site. It then feels as though it is creeping up your arm - then it "jumps" from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized. The anesthesiologist or surgeon will then determine if you are sedated properly, your stats are stable and if you are ready for the surgery to begin. You will be injected with a solution of Lidocaine for pain relief and epinephrine for vasoconstriction. Vasoconstrictors impede your skin's ability to bleed excessively by narrowing the bore of the blood vessels. This is usually necessary for dermabrasion during deeper resurfacing procedures. However, not all procedures will need injections of epinephrine. Your surgeon will then begin to manually abrade your skin with a fine grit type of surgical "sandpaper" or with a "sanding" machine somewhat similar to a Dremel® or acrylic nail sander. Your surgeon may make several passes or one simple, yet deeper pass until the scar is at the same level as the surrounding skin. Some scars are removed completely whereas some "ice pick" type scars may need additional procedures such as punch-grafting or injectable fillers. After the skin resurfacing is complete, your surgeon will cover your face with either a thin film of Bacitracin or antibiotic burn cream like Silvadine. Some surgeons use a second synthetic breathable skin to protect the newly surfaced tissue during its healing process. There are several experimental coverings that are undergoing testing. Some will even provide you with or suggest that you get a hydrogel-type masks or sheeting. Some bandages consists of several layers, the main layers consisting of the purified "crab shells" (chitosan) as well as a synthetic barrier that whisks away moisture and fluids from a weeping, healing wound. An outer layer of cotton gauze absorbs the fluids. The gauze pads can be changed but the synthetic skin and chitosan covering stays to protect the wound. The chitosan are actually absorbed harmlessly into the body and excreted. Miraculously, the crab shells have a superior antibacterial property unheard of in any relative substance. Reportedly, no known fungus or germ can adhere to its surface. When the bandage is removed - perfect, "flawless" skin appears. You are then gently awakened and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released. This is dependent upon the individual but may take up to two hours. Your face may feel tight and quite tender as the anesthesia wears off. You may even feel emotional or upset - this will depend upon your body's reaction to anesthesia. You may also experience "rigors" or shivering. This may feel uncontrollable and is usually from the medications - more than likely if epinephrine is used (a vasoconstrictor). The recovery nurse usually has wrapped you in a warm blanket but if not, request one. It certainly makes things more tolerable. Following surgery, the treated area is slightly swollen and may appear as a mild burn. The face generally returns to its normal color in several weeks. You may experience a burning or throbbing sensation, although medication can alleviate much of this discomfort. Ointment is applied to soothe the face and help minimize the amount of scabbing you experience. Sun and other irritants (strenuous activity, wind, and contact) should be avoided for several months. Patients can expect to return to work in two weeks. You may be groggy from the anesthetic and or oral medications and probably won't remember much of the first day or two if you were sedated. You will have to take it easy and sleep on two pillows to keep your head elevated for 7-14 days - or however long your surgeon suggests. When you wake up you will notice that your face may look even more swollen in the first 3 days. But, as the days go on the swelling will dissipate. There may be some bruising, but this will go away, as well. So make a mental note of this or you may be shocked into a depression. Bruising and swelling are a normal occurrence in most invasive procedures. In dermabrasion, there is marked redness and weeping (wound seepage). There will be redness and slight discomfort post-operatively. Your surgeon will have instructed you on the proper care of your treatment area as well as prescribed you the necessary antibiotics and pain medications to help alleviate your discomfort. Take your temperature on time and regularly. An elevated temperature could mean an infection. Take those antibiotics ON TIME. And don't forget if you are taking birth control that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well. The swelling can be alleviated with ice packs. You may be instructed to apply ice (not directly on skin), gel masks and vinegar soaks on your treatment area for the first 48 hours. Your healing time totally depends upon the depth of your treatment. You can expect to be down for at least 1-2 weeks - unless the treatment is very superficial. Your skin will feel like a wind or sun burn. It may weep and need dressing changes and additional ointments which will be supplied by your doctor directly or by prescription. You may sometimes wear these bandages for about 5 to 7 days. You will more than likely have them removed by your doctor on day 5 but this could be longer if the penetration was pretty deep. After your bandages are removed your doctor will go over with you the proper care for your treatment area such as cleansing and applying ointment. If you notice crusty formations; DO NOT PICK AT THEM OR PULL THEM OFF! You will scar as a result - probably more than before your treatment. But, don't worry; they usually subside by day 10. You may be given a bovine mucalpolysacharide solution or wash; this is a cow-derived cartilage extract that has the anti-inflammatory properties of 1-2% hydrocortisone. It accelerates epidermal healing. The skin wash is like having a steroid application without the risk of steroid induced atrophy or telangiectasia formation. Post-operatively, you must use sun block faithfully! Your skin is very susceptible to damage by UVA/UVB radiation (the sun). This includes artificial sunlight like tanning beds as well as simply driving to the store or around town all day in your car. Believe it or not you do get sun exposure when you drive around. You should not use using AHA's, Vitamin A (Retin A) or exfoliants until your surgeon advises it is safe to do so. Your skin is very fragile in its healing stage - which could last for months. You may be pink for up to 5 months or more, depending on your skin's ability to "bounce back" and, of course, the depth of the abrasion. You must take care of your skin in order to keep it looking vibrant and fresh. Although, no procedure can keep your skin from aging - it can give you a young, relaxed appearance and "buy you some time". At about 2 weeks or as soon as there is no weeping and no crusting (but please ask your doctor first) you can safely wear cosmetics to cover the redness. There are special cosmetics one can buy to offset the redness or you can experiment on your own with what you have. As with any cosmetic surgery, complications are rare, but include infection and scarring. Should infection occur (indicated by a sallow or yellowish tinged crusting around the scab), immediately consult your doctor. Other concerns include permanent alterations in the skin's pigment, turning either darker or lighter in tone. When only one section of skin is treated, the face may appear slightly spotty. If you smoke, your surgeon will recommend that you quit both two weeks prior to and following surgery. We continually update this site to keep you informed of the latest scientific findings about rosacea. Click below to access another page within the INTERNATIONAL ROSACEA FOUNDATION site, or a related website. 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